balgrist 2011 ankle arthrodesis vs. arthroplasty · balgrist 2011. ankle arthrodesis vs....
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Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
Ankle Arthrodesis vs. ArthropastyAnkle Arthrodesis vs. Arthropasty
Hans-Jörg Trnka
Foot and Ankle Center Vienna
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
►
Ankle arthrodesis was for many years the gold standard forankle arthritis
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
How difficult is a revision of a failed TAA?
Jim Nunley
„I tell my patients that at some point an oil change will be necessary“
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
It is not just an oil change
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
61 year old patient
1 y post OP pain 2 y after first change: pain
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
Another change and again
pain
Next surgery more pain
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
Patient now on pain medication
Einleitung
OSG
Hohlfuß
Plattfuß
Charcotfuß
Revisionen
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
Femoral head +nail
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
► 271 patientsAv. age 58,4 yearsFU 36,1 months (12 –
64)
93 % excellent and good
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
Prospective comparative study16 Arthrodesis vs. 14 TAAAOFAS SCALESF-36
The Journal of Foot and Ankle Surgery 50 (2011) 383-387
„Based on our results………the arthroplasty produces better results than the fusion
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
Always made a TTC arthrodesis
2 talar necrosis
50% complications
AES prosthesis
Taken from the market
30% complications
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
Our own study:
Aim of this retrospective study was to determine if there is any difference in functional outcome with
biomechanicly objective assessment tools and
participation in sports and recreational activities in patients who underwent ankle arthrodesis and TAA respectively in a single surgeon population.
►
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
Posttraumatic ankle arthrosisIdiopathic ankle arthrosis
Post septic ankle arthrosisNeurological deformity
IndicationsIndications
►
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
Arthrodesis demograhics TAR
21 Number of patients 28
64 ± 10.8 (40 - 84) Age 56 ± 14.0 (34 - 85)
169 ± 7.6 Height (cm) 171 ± 9.4
80.32 ± 10.66 Weight (kg) 80.67 ± 10.84
10:12 Gender (m:f) 14:14
Patients & Methods
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
8 weeks ankle arthrodesis8 weeks ankle arthrodesis6 weeks ankle arthroplasty6 weeks ankle arthroplasty
Postoperative protocolPostoperative protocol
►
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
Investigative tools
AOFAS Score
Sports activities
Radiographic evaluation
Pedobarography
Gait analysis
►
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
Radiological examination
Radiographs: Foot weightbearing
ap:Ankle
lateral:ankle
►
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
•Total object•Toes 1, 2 and 3 – 5•Metatarsal heads 1, 2, 3, 4, •Midfoot •Hindfoot
At f/u the AOFAS hindfoot score1, patient‘s satisfaction were evaluated.
Additionly, plantar pressure distribution was assessed and patients were asked about their participation in sports and recreational activities
before the onset of restricting symptoms and at f/u
Plantar pressure distribution assessment was performed using the emed at platform (Novel GmbH
Munich)Foot was divided into following regions of interest:
and peak pressure as wellas contact time have been calculated
1Kitaoka et al., Foot
Ankle Int. 94
►
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
Gait analysisGait analysis
Measurement of hindfoot angle
►
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
Arthrodesis demograhics TAR
21/21 Available for the study 21/28
Lost patient3 arthrodesis2 revisions
2 did not show up
29 ± 22.7 F/u (months) 36 ± 18.8
RESULTS
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
Pre op6 weeks
3 years After revision
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
AOFAS scoreAOFAS ‐ S core
73
78
P rothes e Arthrodes e
►
Zufriedenheit im Verg leich in %
83,3
5,6 110 0
77,3
9,1 4,5 4,5 4,5
S ehr Zufrieden Zufrieden Mäß ig Zufrieden Wenig Zufrieden Nicht Zufrieden
Arthrodes en P rothes en
Patient satisfaction
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
burgstaller nordic walk ing
84 AOFAS points3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
Radiographic evaluation
►
Tibio-talar angle:
89° (82 – 100)
No pseudarthrosis
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
Radiographic evaluation
►
Tibia:
6 cases of loosening lines
3 cases of loose implant
Talus:
1 case of loosening lines
2 cases of loose implant
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
ROM ankle arthroplasty
►
: 23: 23°° (12 (12 –– 47,547,5
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
5 y FUAOFAS 91 points
Post OP
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
Sports activities
►
S ports before s urg ery
0 10 20 30 40 50 60 70 80
TennisF uß ball
S chifahrenWandernRudern
S chwimmenTanz en
R adfahrenNordic Walking
LanglaufenGymans tikE is laufenReiten Laufen
Handball
Arthrodes e
P rothes e
S ports after s urg ery
0 10 20 30 40 50 60
Tennis
F uß ball
S chifahren
Wandern
Rudern
S chwimmen
Tanz en
Radfahren
Nordic Walking
Langlaufen
Gymans tik
E is laufen
R eiten
Laufen
Handball
Arthrodes e
P rothes e
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
Pain
►
Inc idence of pain
0
10
20
30
40
50
Nie Monatlich Wöchentlich Täglich Immer
P rothes en Arthrodes e
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
Pre OP 6 weeks
5 y FUAOFAS: 78 points
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
What is the evidence in the literature?3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
Advantage Endosprosthesis
Mobility (ROM maintained)Avoid der Subtalar und Talonavic.
arthrosisJung HG, Parks BG, Nguyen A, Schon LC.: Effect of tibiotalar joint
arthrodesis on adjacent tarsal joint pressure in a cadaver model. Foot Ankle Int. 28/1: 2007
Significant pressure after ankle fusion in the talonavicular and subtalar joint
Short RehabilitationEvolution of surgery
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
Ankle arthrodesis and its relationship to ipsilateral arthritis of the hind‐
and
mid‐foot B. D. Sheridan, BSc(Hons),et al. and I. G. Winson, MBChB, FRCS,
Journal of Bone and Joint Surgery ‐
British Volume, Vol 88‐B, Issue
2, 206‐207.
70 Patientes / 71 ArthrodesesAll had adjacent arthroses
The presence of such changes may not be a consequence of this arthrodesis.
Arthrodesis
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
23 patients, 22 y FU,
6/23 in correct position
Adjacent arthrosis in all cases
Coester C., Salzman et al.: Longterm Results of ankle arthrodeses for posttraumatic DJD. JBJS A -2001
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
Results Transferarthrosis revision rate
SooHoo N.F., Zingmond D.S., Ko C.Y.: Comparison of
reoperation rates following ankle arthrodeses and total ankle
arthroplasty. JBJS 89(10): 2007
Revision rate:
4705 Arthrodesis vs. zu 480 OSG endoprosthesis:
1 year:
5:11%
5 year:
9:23%
Risk:
1,5 : 2,49
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
49Studien aus 460 Publik.(Meta Analyse - Confidence Interval)
Arthrodese39(n=1262)
Prothese10(n=852)
AOFAS 75,6 78,2 Excellent/good 31%/37%=68% 38%/30,5%=68,5%Fair/poor 13%/13%=26% 5,5%/24%=29,5%5/10Jahre Survival 100% 78%/77%Revision 9% (Pseudoarthr.) 7% (Lockerung/Migration)
BKA - 5% 1%
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
28% Revisions11% Total Failures ( 8 Amputations,
25 arthrodeses)
Total Ankle Arthroplasty With the Agility Prosthesis:Clinical and Radiographic Evaluation
Kopp FJ, Mihir MP, Deland JTFoot & Ankle Int., Vol. 27, No. 2, 2006
39% revisions97% Survival rate ?????????????
85% loosening zones
►
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
24% Revisionrate14% looseing rate12% not satisfied24% painfree
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
AUTOREN JAHR N Pseudarthr.Rate
Morgan et al 1985 101 5(5%)
Frey et al 1994 41%
Chen et al 1996 42 1(2,5%)
Flamme et al 1997 25 5(20%)
Kitaoka et al 1998 19 3(16%)
Rowan et Davey 1998 33 2(6,7%)
Mann et al 1998 81 10(12%)
O´Brian et al 1999 17 3(18%)
Taylor et al 1999 18 2(12%)
Anderson et al 2002 29 3(11%)
Muckley et al 2003 110 11(10%)
Fuchs et al 2003 18 1(6%)
Trieb et al 2004 34 4(11,7%)
Thomas et al 2006 26 0(0%)
Schuh et al 2011 20 0(0%)
Ankle fusion results
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
PTS. TIME FUSIONMann (open) 81
13.8 wks
88%
Scranton (open) 25
12.0 wks
100%
Myerson (open) 16
14.5 wks
100%
Mann (scope)
78 8.0 wks
91%
Crosby (scope) 42
5.5 mo
74%
Fusionsrate
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
50 years FU
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
Despite more costly implants and longer FU, TAA remains a cost effective alternative to anklefusion in a 60 year old cohort
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
At 1 year no difference in Quality of Life
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
Atomic bomb?
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
FAILURES????
EASY TO HANDLE`??????
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
Post OP picture in cast„OK“
Einleitung
OSG
Hohlfuß
Plattfuß
Charcotfuß
Revisionen
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
Nach 4 Wochen doch Revisionmit Zement
Post OP Bild im Gips
Einleitung
OSG
Hohlfuß
Plattfuß
Charcotfuß
Revisionen
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
Nach 4 Wochen Explantation und Gips
Einleitung
OSG
Hohlfuß
Plattfuß
Charcotfuß
Revisionen
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
Weitere 4 Wochen„wir sollten doch versteifen“
Oh es gibt 2 Ebenen im RÖ
Einleitung
OSG
Hohlfuß
Plattfuß
Charcotfuß
Revisionen
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
Noch ein Versuch Vielleicht nur Gips???
Einleitung
OSG
Hohlfuß
Plattfuß
Charcotfuß
Revisionen
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
Fibulainterponat, Hüftkopf, winkelstabile Verplattung
Einleitung
OSG
Hohlfuß
Plattfuß
Charcotfuß
Revisionen
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
Pre op Post op
3 y FU After revision
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
63 years old
3 y FUAOFAS 90 points
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
„Publications by some research groups particularly by implant inventors
Show deviation from the published outcome by others users and the registry data.“
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
Conclusion• Comparison of the clinical results
• Sports activities
Higher complication rate with the arthroplasty
No significant diffference
More sports with the arthroplasty
• Pedobarography
Higher patient satisfaction and AOFAS with arthrodesis
►
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
Conclusion
A well functioning arthroplasty is better than a well functioning arthrodesis
Select your patients well if you are in doubt, fuse it
►
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
Thank you…
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
Patient : B.G. 60a
OSG Arthrodesis left
Patient very satisfied
AOFAS - Score 84
3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011
Ankle arthrodesis vs. ArthroplastyBalgrist 2011
Introduction
Pat & Meths
Results
Discussion
Conclusions
For heavy working safety is importantThis is a farmer
Arthrodese
OSG Arthrodese3rd Foot and Ankle Symposium
Arthritic Disorders of the Foot and Ankle
Diagnosis and Management
UNIKLINIK BALGRIST
September 9th, 2011